The primary goal for using follicular unit grafts is to assure a natural look, i.e. hair that does not look like it was transplanted. Another key goal of follicular unit grafting is the enhancement of density. Unfortunately, surgery can only replace a percentage of the lost hair for the majority of patients because of donor supply and technical limitations. In comparison to the density of our youth, the experienced surgeon must use a smaller number of hairs to produce the fullest, most dense look possible. The creation of a full look by implanting hair at relatively lower density has been referred to as the "illusion of density". It is the artistry of the surgeon and unique physical characteristics of the patient that allow the "illusion of density" to produce the fullest, most dense look possible.
Density is defined as the number of grafts implanted per square centimeter in a transplanted zone. Hair density is interpreted visually as how thick or thin a transplant zone appears. A number of physical and technical variables affect the appearance or "illusion" of density. It is important to understand the principles of density as the target density one desires will have implications regarding the number of grafts needed, the area that can be covered, and the donor site's ability to provide hair for future use.
The target density for a particular surgery is based on the patient's visual goals. The possibilities for achieving any given target can easily be determined by an experienced hair surgeon. Patient goals may or may not be feasible depending on donor resources. In younger patients and those desiring to fill large areas, density objectives need to assessed with respect to the ability to meet goals without unwisely depleting donor resources. Density considerations involve a balance between conserving donor hair for the future and the wisest use of donor hair to achieve goals and expectations for today. An educated patient is one who understands the principles of density and who uses valuable donor hair resources wisely.
HAIRLINE RESTORATION USING DENSE-PACK GRAFTING TECHNIQUE
GENERAL PRINCIPLES RELATING TO DENSITY
1) Density is directly related to the number of grafts placed in a given area. Density decreases as any number of grafts are spread over a larger area. A patient who chooses to double the recipient zone area using any predetermined number of grafts will decrease the overall density by fifty percent.
2) It is commonly recognized that approximately 50% of the original density is needed to produce the appearance of high density hair. A 50% density requires approximately 40-50 grafts per square centimeter.
3) Several factors besides overall hair count contribute to the appearance of density. Hair texture, hair caliber, average follicular unit hair count, hair/skin color combination and hair shaft rigidity all influence the perception density. One cannot accurately use graft counts to compare density between different patients without matching these physical characteristics.
4) Grafting to or beyond 50% density is not feasible for most patients with advanced balding patterns because of limitations imposed by graft availability in the donor region.
5) There are limits to the density of hair that can be planted in a zone with preexisting thinning hair as the risk of "shockloss" rises with increasing graft densities.
6) Multiple sessions will be required to achieve the appearance of high density unless dense-packing is performed (approximately 40-50 grafts per square centimeter).
7) Graft number requirements for any given session are based on the grafting density performed and the size of the zone being grafted.
8) Cosmetically acceptable density varies from person to person.
9) One's long-term density potential is based on graft availability from the donor region. Donor hair supply typically diminishes with time, especially if the balding process has not stabilized and the pattern has the potential to advance with age.
10) It is common and expected that a patient perceive the transplanted density as being thin rather than thick when less than 50% density restoration has been recommend at consultation. In this case more than one surgery may be needed if high density is desired.
To contact our Chicago area office in Oakbrook Terrace for a preliminary assessment of your hair loss, complete the virtual consultation form or call us at 630-932-9690.